Gastrointestinal motility disorders in scleroderma

Sjogren, Robert W.

doi:10.1002/art.1780370902

Cited by 334 publications

(276 citation statements)

References 107 publications

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“…This leads to the assumption that the effects of esophageal dysmotility in SSc patients may be higher than estimated by the regression models. Similarly, there are distinct differences with regard to the involvement of the lower GIT when compared to other studies [8,14].…”

Section: Discussionmentioning

confidence: 65%

Profile of gastrointestinal involvement in patients with systemic sclerosis

et al. 2011

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Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disease. Of the numerous organ manifestations, involvement of the upper and lower gastrointestinal tract (GIT) appears to be the most frequent with regard to the clinical symptoms. However, as the frequency and clinical relevance of GI involvement in patients with SSc are not known in detail, the German network of the systemic sclerosis (DNSS) has developed a detailed questionnaire to evaluate the extent and profile of gastrointestinal involvement in SSc patients. The multi-symptom questionnaire was used at baseline and after 1 year in registered patients of the DNSS. In addition, the results were compared with gastrointestinal disorders in patients with SSc and other rheumatic diseases, as well as with the medical history of the patients. In total, 90 patients were included in the study. The results of the study show that in reality, a much higher (nearly all) percentage of (98,9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. Of these, meteorism (87,8%) was the most common followed by coughing/sore voice (77,8%), heartburn (daytime 68,9%, nighttime 53,3%), diarrhea (67,8%), stomach ache (68,9%) and nausea (61,1%). Although SSc patients were treated according to the respective recommendations, only limited improvements with regard to GI-symptoms could be achieved after 1 year of follow-up. In addition, the study revealed that the multi-symptom questionnaire is a useful tool to contribute to identify the gastrointestinal sequelae in systemic sclerosis. Methods: The multi-symptom questionnaire was used at baseline and after one year in registered patients of the DNSS. In addition the results were compared with gastrointestinal disorders in patients with SSc and other rheumatic diseases, as well as with the medical history of the patients. In total, 90 patients were included in the study. Results: The results of the study show that in reality a much higher (nearly all) percentage of (98,9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. Of these, meteorism (87,8%) was the most common followed by coughing/ sore voice (77,8%), heartburn (daytime 68,9%, nighttime 53,3%), diarrhea (67,8%), stomach ache (68,9%) and nausea (61,1%). Conclusions: Although SSc patients were treated according to the respective recommendations, only limited improvements with regard to GI-symptoms could be achieved after one year of follow up. In addition, the study revealed that the multi-symptom questionnaire is a useful tool to contribute to identify the gastrointestinal sequelae in systemic sclerosis. Methods:The multi-symptom questionnaire was used at baseline and after one year in registered patients of the DNSS. In addition the results were compared with gastrointestinal disorders in patients with SSc and other rheumatic diseases, as well as with the medical history of the patients. In total, 90 patients were included in the study. Results:The results of the study show tha...

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Section: Discussionmentioning

confidence: 65%

Profile of gastrointestinal involvement in patients with systemic sclerosis

et al. 2011

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“…The gastrointestinal tract is the second most commonly involved site (1). The most frequently involved area of this tract is the esophagus, affecting 75-90% of patients with SSc (1)(2)(3)(4). Damage is prominent in the distal two-thirds of the esophagus, resulting in abnormal esophageal motility.…”

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confidence: 99%

Prevalence of Barrett's esophagus in systemic sclerosis

Wipff¹,

Allanore²,

Soussi³

et al. 2005

Arthritis & Rheumatism

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Objective. The esophagus is the most commonly affected gastrointestinal area in systemic sclerosis (SSc). Patients with SSc frequently develop gastroesophageal reflux, esophageal injury, and sometimes, intestinal metaplasia, or Barrett's esophagus (BE), which may increase the risk of esophageal adenocarcinoma. This study sought to determine the prevalence of BE and esophageal adenocarcinoma in a cohort of SSc patients.Methods. One hundred ten SSc patients who were receiving long-term treatment with proton-pump inhibitors (PPIs) were assessed systematically by esophageal manometry and endoscopy. Esophageal biopsies were performed when macroscopic abnormalities were detected, and BE was diagnosed histologically.Results. Among the 110 patients, 14 had BE (12.7%). None of the patients with BE had adenocarcinoma, but 3 of the 14 patients (21%) had dysplasia on esophageal biopsy. Similar proportions of patients with and without BE had abnormal peristalsis and decreased lower esophageal sphincter pressure. No association between BE and other disease characteristics was demonstrated.Conclusion. In this study, 12.7% of SSc patients who had been treated with PPIs for long periods had BE, similar to the prevalence in patients with gastroesophageal reflux disease. Although none of the patients had esophageal adenocarcinoma, patients with BE should be followed up closely, particularly patients with dysplasic BE. Long-term prospective studies are warranted to determine the phenotype of SSc patients at high risk of developing dysplasia or esophageal adenocarcinoma.

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“…Seis pacientes que apresentaram estenose esofágica previamente à cirurgia anti-refluxo e necessitaram dilatações endoscópicas não apresentaram estenose no período pós-operatório. Epitélio colunar metaplásico é freqüente na DRGE por causa da ES, podendo ocorrer em um terço dos pacientes (2) , e o tratamento cirúrgico não interfere com sua permanência. Sendo assim, nossa escolha de tratamento no único caso de esôfago de Barrett foi ablação a laser após a fundoplicatura laparoscópica.…”

Section: Discussionunclassified

“…Percival D. Sampaio-Barros (1) , Luis Roberto Lopes (2) , Nelson Adami Andreollo (2) , André Gusmão Cunha (3) , Adil Muhib Samara (4) , Nelson Ari Brandalise (5) …”

Section: Surgical Treatment Of Gastroesophageal Reflux Disease In Sysunclassified

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Tratamento cirúrgico da doença de refluxo gastroesofágico na esclerose sistêmica

Sampaio-Barros¹,

Lopes²,

Andreollo³

et al. 2004

Rev. Bras. Reumatol.

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RESUMOObjetivo: Os autores descrevem sua experiência com o tratamento cirúrgico da doença de refluxo gastroesofágico (DRGE) em pacientes com esclerose sistêmica (ES). Métodos: Foram selecionados 10 pacientes com DRGE que apresentavam esofagite grave e estenose esofágica, tratados previamente com doses recomendadas de drogas anti-secretórias (ranitidina e/ou omeprazol) e pró-cinéticas (cisapride) por mais de seis meses, sem melhora significativa. Todos os pacientes eram do sexo feminino e 8 eram caucasóides, sendo 7 com ES limitada e 3 com ES difusa. Resultados: O tratamento cirúrgico foi realizado através de videolaparoscopia em 9 pacientes e por cirurgia aberta no outro paciente. Sete pacientes foram submetidos à técnica de Nissen modificada e 3 à técnica de Lind. Seis pacientes com estenose esofágica significativa necessitaram de dilatações endoscópicas no período pré-operatório. Avaliação pós-operatória três meses após a cirurgia revelou que 70% dos pacientes apresentaram resultado favorável, com melhora significativa da azia e da disfagia; 1 paciente necessitou de nova intervenção cirúrgica em conseqüência de uma hérnia paraesofágica no período pós-operatório, sendo realizada uma gastrectomia em Y de Roux. Uma boa evolução foi referida por 80% dos pacientes um ano após cirurgia e por 70% dois anos após cirurgia, observando-se dois óbitos. Conclusões: Os autores concluem que o tratamento cirúrgico da DRGE representa uma eficiente opção terapêutica em pacientes com ES e esofagite grave com estenose.

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Gastrointestinal motility disorders in scleroderma

Cited by 334 publications

References 107 publications

Profile of gastrointestinal involvement in patients with systemic sclerosis

Profile of gastrointestinal involvement in patients with systemic sclerosis

Prevalence of Barrett's esophagus in systemic sclerosis

Tratamento cirúrgico da doença de refluxo gastroesofágico na esclerose sistêmica

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